What is adjunctive therapy?

What is adjunctive therapy?

So adjunctive therapy just means that you're adding an extra therapy on to a standard of care, so to speak. So, you know, when we talk about standard of care therapy for myeloma, that's usually a three or four drug combination. So the adjunctive therapies would be some agents that have some other potential benefit or either either some potential benefit against the myeloma or some therapy that has potential benefit in other types of disorders, that myeloma causes, other types of problems that myeloma causes, such as, bone directed therapy because that we know that myeloma will interfere with the integrity of our bones. Sometimes we give agents to help bring someone's hemoglobin back up if their hemoglobin has taken a drop because they're anemic from the myeloma, things like that Is dialysis adjunctive therapy. you could call dialysis an adjunctive therapy. I mean, certainly if somebody needs dialysis, that becomes more of a primary therapy. If their kidneys have failed, something like plasma exchange for someone who has something like hyper viscosity where you're trying to prevent their kidneys from failing would be more classically in adjunctive therapy. You would start them on chemotherapy, but you would also try to extract all of the the myeloma in their blood, out of their blood as quickly as possible before it causes significant damage.

Are antivirals adjunctive therapy?

So the antivirals are a good example. So we're trying to prevent the reactivation of some viruses. You know, when we target myeloma cells, we oftentimes, unfortunately get some collateral damage with our normal plasma cells. So some of our normal plasma cells help prevent us from getting certain viruses, things like the shingles virus which lives inside of our body at all times. But our body is able to keep it under control. When we give patients myeloma therapy, oftentimes their body loses the ability to control that because we've attacked some of the normal plasma cells as well. So medications to prevent the shingles reactivation are certainly important. Those would be medications like acyclovir or valacyclovir.

Is pain medication adjunctive therapy?

So absolutely. I mean, if someone's having unfortunate complications of myeloma, including cancer pain, which is very common, then you're giving them pain medications is really an important part. You know, if you can't control someone's pain, that's obviously going to affect their quality of life and make it that much more challenging for them to fight this thing. So, you know, anything that we can do to help them, help us to beat to fight this thing is certainly important.

Are vaccines adjunctive therapy?

So absolutely. So, you know, I think that that should be, a super important part of patients who have myeloma is care to make sure that they're up to date on all of their vaccines. I like to think of myeloma as a chronic disease. We cannot cure myeloma as of 2021, but we're getting a lot closer. But I expect my patients to live a long time. So I want them to make sure that they're not missing out on some of their other, routine maintenance, so to speak, that they're getting their appropriate screening tests, that they're seeing their primary doctor and getting their cholesterol checked and getting their colonoscopies done and things like that, and also getting their their vaccines, because certainly myeloma patients are at higher risk for infections. Even patients in remission are at higher risk of infection. So we certainly want to do everything in our power to decrease that risk.